How much rates vary
Facilitymedian $372 · 10th to 90th $214 to $617Professionalmedian $331 · 10th to 90th $151 to $490
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier None Typical Low $257.04 Median $331.13 Typical High $331.13 | Professional | None | $257.04 | $331.13 | $331.13 |
BCBS Idaho Setting Facility Modifier None Typical Low $302.00 Median $371.54 Typical High $616.60 | Facility | None | $302.00 | $371.54 | $616.60 |
BCBS Idaho Setting Professional Modifier None Typical Low $269.15 Median $407.38 Typical High $426.58 | Professional | None | $269.15 | $407.38 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $218.78 Median $218.78 Typical High $234.42 | Facility | None | $218.78 | $218.78 | $234.42 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $218.78 | Professional | None | $158.49 | $158.49 | $218.78 |
Moda Health Setting Facility Modifier None Typical Low $97.72 Median $331.13 Typical High $389.05 | Facility | None | $97.72 | $331.13 | $389.05 |
Moda Health Setting Professional Modifier None Typical Low $257.04 Median $346.74 Typical High $407.38 | Professional | None | $257.04 | $346.74 | $407.38 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $288.40 Typical High $331.13 | Professional | None | $30.20 | $288.40 | $331.13 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $245.47 Median $489.78 Typical High $23,442.29 | Facility | None | $245.47 | $489.78 | $23,442.29 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $389.05 Median $489.78 Typical High $27,542.29 | Professional | None | $389.05 | $489.78 | $27,542.29 |
Regence BlueShield Setting Facility Modifier None Typical Low $363.08 Median $371.54 Typical High $562.34 | Facility | None | $363.08 | $371.54 | $562.34 |
Regence BlueShield Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $407.38 | Professional | None | $269.15 | $269.15 | $407.38 |
Select Health Setting Facility Modifier None Typical Low $363.08 Median $389.05 Typical High $501.19 | Facility | None | $363.08 | $389.05 | $501.19 |
Select Health Setting Professional Modifier None Typical Low $251.19 Median $389.05 Typical High $407.38 | Professional | None | $251.19 | $389.05 | $407.38 |
United Setting Facility Modifier None Typical Low $199.53 Median $199.53 Typical High $204.17 | Facility | None | $199.53 | $199.53 | $204.17 |
United Setting Professional Modifier None Typical Low $138.04 Median $151.36 Typical High $223.87 | Professional | None | $138.04 | $151.36 | $223.87 |
9 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $128.82 Median $165.96 Typical High $165.96 | Professional | 52 · Reduced service | $128.82 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $66.07 Typical High $66.07 | Professional | 53 · Discontinued | $51.29 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $50.12 Typical High $50.12 | Professional | 55 · Aftercare only | $38.90 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $33.11 Typical High $33.11 | Professional | 56 · Pre-op care only | $25.70 | $33.11 | $33.11 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $288.40 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $257.04 | $288.40 | $302.00 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $128.82 Median $165.96 Typical High $165.96 | Professional | 52 · Reduced service | $128.82 | $165.96 | $165.96 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $66.07 Typical High $66.07 | Professional | 53 · Discontinued | $51.29 | $66.07 | $66.07 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $50.12 Typical High $50.12 | Professional | 55 · Aftercare only | $38.90 | $50.12 | $50.12 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $33.11 Typical High $33.11 | Professional | 56 · Pre-op care only | $25.70 | $33.11 | $33.11 |
Where Idaho sits
The same service costs 3.3 times more in Hawaii than in West Virginia. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Idaho· 4th of 51
$331
HI $525WV $158
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.